The pharmacy department at Toronto's North York General Hospital (NYGH) has found that an RFID kit-checking solution that it recently installed to manage its pharmaceutical trays not only eliminates errors, but also reduces tray-restocking times by, on average, 4.9 minutes. That equals 659 labor hours saved annually, according to Edith M. Rolko, NYGH's director of pharmacy and infection prevention and control.

With the Intelliguard Kit and Tray Management System, developed by MEPS Real-Time Inc., a passive ultrahigh-frequency (UHF) RFID tag is attached to each medication, which is then put in a tray and placed inside of a workstation with a built-in Impinj RFID reader. The system also comes with Intelliguard software, residing on the pharmacy department's database, that links each tag ID number with the medication's name, dosage, Drug Identification Number (DIN), National Drug Code (NDC) number, lot number and expiration date. The purpose is to ensure that trays are accurately restocked, with nothing missing or expired.

NYGH's Edith Rolko

North York General Hospital is affiliated with the University of Toronto, and is one of the largest community academic hospitals in Canada offering acute-care, ambulatory and long-term services. Its pharmacy department employs 35 pharmacists and 35 technicians who not only fill individual medication prescriptions for patients, but also prepare and manage the trays that are sent to patient-care departments for use on an as-needed basis.

The majority of the trays are dedicated to resuscitations, and are transported around the hospital in crash carts for use during emergency events. The pharmacy provides two types of resuscitation trays for adults, and one for pediatric patients. The pharmacy department also supplies OR tray medications typically used by anesthesiologists. Altogether, there are 28 OR trays, 104 resuscitation trays, six trays for labor and delivery, six for endoscopy and five OR trays for day surgeries performed at the hospital's ambulatory care site. Trays commonly have between 78 and 138 medications packed in them, which has been traditionally very difficult for an RFID system to read.

Before the automated system was implemented, a pharmacy technician would need to manually check every medication in every tray sent back to the pharmacy department after it was used. This process of identifying any missing drugs, and thereby ensuring that none are nearing expiration dates or have been recalled, was extremely labor-intensive, the hospital reports, and could only be carried out by a technician with certified training. In the case of trays used for resuscitating a patient, a second individual would check the first technician's work.

Regulations vary in Canada and the United States—in some provinces or states, a technician must complete this task, after which a pharmacist must check that person's work. In some locations, such as in Ontario, regulated technicians can do the work themselves as part of their scope of practice. However, North York still required that a second technician confirm that each resuscitation tray was packed accurately before it could be sent to one of the hospital's departments. With the Intelliguard System, the second technician review is no longer necessary.